A population-based study of fatal and nonfatal firearm-related injuries

Objective: To determine population-based firearm-related morbidity and mortality for Allegheny County, PA (population = 1.3 million), for the year 1994. Methods: Fatalities were identified from a review of death certificates. To identify nonfatal cases, an active surveillance was conducted at all 24 acute care EDs in the county, The ED surveillance used 2 existing sources of case identification from each hospital to minimize undercount. Results: Firearms were the leading cause of injury death to county residents, accounting for 155 deaths. The crude mortality rate from firearms was 11.7/100,000. Black males aged 15-19 years were most at risk for a firearm fatality (293/100,000). There were 514 nonfatal firearm injuries, producing a case fatality rate of 23%. The highest age-specific rate for nonfatal firearm-related injuries treated in the county EDs was observed for black males aged 15-19 years (2,245/100,000), which is 58 times higher than the firearm-related injury rate for the entire county population (38.7/100,000). Conclusion: Firearm-related injury and death are a significant public health problem in Allegheny County, Although the crude mortality rate from firearms in the county is lower than the reported national rate, the observed rate for nonfatal injuries in the black youth of this community is the highest firearm injury incidence rate ever reported, Local surveillance of firearm-related injuries, including nonfatal events, is needed to more accurately demonstrate the magnitude of this problem.